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Ciccarone Center Research
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- Antiplatelet Therapy
- ASCVD (Atherosclerotic Cardiovascular Disease)
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- Family History of CVD
- Gender / Cardiovascular Disease in Women
- Heart Failure
- Heart Rate
- Markers of Thrombosis, Myocardial Injury, Wall Stress
- Mobile Health
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- PVD – Peripheral Vascular Disease
- Quality of Care
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- Sleep Disorders
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View by Journal
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- Meet the Authors
Cholesterol / Lipids / Statins
To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.Published in: Journal of the American Heart AssociationRead on Pubmed
This is a state-of-art review on the possible effects of statin therapy on organs not in the cardiovascular system.Published in: British Medical JournalRead on Pubmed
Headed in the right direction but at risk for miscalculation: a critical appraisal of the 2013 ACC/AHA risk assessment guideline.
The newly released 2013 ACC/AHA Guideline for Assessing Cardiovascular Risk was a major advance over prior guidelines, but the new risk equations do not appear to lead to significantly better discrimination than older models. Since the same risk factors are incorporated, using the new risk estimators may lead to inaccurate assessment of atherosclerotic cardiovascular risk in certain groups of patients. There also is likely an overestimation of risk when applied to modern populations. Future guidelines could provide clearer direction on which individuals would benefit from additional testing for more personalized preventive therapies.Published in: Journal of the American College of CardiologyRead on Pubmed
Concepts and controversies: the 2013 American College of Cardiology/American Heart Association risk assessment and cholesterol treatment guidelines.
This editorial discusses the strengths and limitations of the new prevention guidelines.Published in: Annals of Internal MedicineRead on Pubmed
Dyslipidemia, coronary artery calcium, and incident atherosclerotic cardiovascular disease: implications for statin therapy from the multi-ethnic study of atherosclerosis.
CAC scoring can help match statin therapy to absolute atherosclerotic CVD risk.Published in: CirculationRead on Pubmed
Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects.
In this study of patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data supports a beneficial role for statins in the prevention of dementia.Published in: Mayo Clinic ProceedingsRead on Pubmed
Effect of equivalent on-treatment apolipoprotein levels on outcomes (from the AIM-HIGH and HPS2-THRIVE).
This viewpoint study seeks to explore the recent failures of the niacin trials through apolipoprotein lens.
Friedewald estimated versus directly measured low-density lipoprotein cholesterol and treatment implications.
This study discovered that, compared with direct measurement, the Friedewald equation tends to underestimate low-density lipoprotein cholesterol (LDL-C) and, therefore, warrants additional evaluation in high-risk patients. Achieving non-high-density lipoprotein cholesterol (HDL-C) targets are important to reach in the secondary prevention setting.
Non-HDL cholesterol, guideline targets, and population percentiles for secondary prevention in a clinical sample of 1.3 million adults: the very large database of lipids (VLDL-2 Study).
There is significant patient-level discordance between non-HDL-C and LDL-C percentiles at lower values of LDL-C and higher triglycerides. Current non-HDL-C cut-points for high-risk patients should be lowered to match percentiles of LDL-C cut-points. Relatively small absolute reductions in non-HDL-C cut-points result in substantial reclassification of patients to higher treatment categories with potential implications for risk assessment and treatment.
The role of statins in diabetes mellitus.
Diabetes is considered a risk equivalent for coronary heart disease (CHD). The use of statins for primary and secondary prevention in patients with diabetes is well established and supported by robust data from randomized, controlled trials and national guidelines. The American Diabetes Association recommends that individuals with diabetes and a history of cardiovascular disease (CVD), as well as those > 40 years of age without CVD but with CVD risk factors, should be treated with a statin regardless of their baseline LDL cholesterol concentration. This review explains the rationale behind considering diabetes a CHD risk equivalent and summarizes the data for statin use in adults with diabetes without (primary prevention) and with (secondary prevention) established CVD. Although individuals with diabetes are at an increased risk for CVD and benefit from statin therapy, the risk of CVD in people with diabetes is heterogeneous. It therefore may be reasonable to match the intensity of statin therapy with patients' baseline CVD risk.
Obesity, adiposity, and dyslipidemia: A consensus statement from the National Lipid Association.
The goal of this statement is to better define the effect of adiposity on lipoproteins, how the pathos of excessive body fat (adiposopathy) contributes to dyslipidemia, and how therapies such as appropriate nutrition, increased physical activity, weight-management drugs, and bariatric surgery might be expected to impact dyslipidemia.
Which serum cholesterol markers should I use to lower my patient’s cardiovascular risk?
We reviewed the strengths and limitations of LDL-C, non-HDL-C, apolipoprotein B, and advanced lipoprotein testing in cardiovascular risk prediction.
Nonfasting lipids: there is the population and then there is the patient.
This article reviews the rationale for the measurements of lipids in the nonfasting state.
The association of elective hormone therapy with changes in lipids among glucose intolerant postmenopausal women in the diabetes prevention program.
It is unclear how lipids change in response to lifestyle modification or metformin among postmenopausal glucose intolerant women using and not using hormone therapy (HT). We examined the one-year changes in lipids among postmenopausal, prediabetic women in the Diabetes Prevention Program (DPP), and whether changes were mediated by sex hormones. The beneficial effects of ILS and metformin on lowering LDL-C and raising HDL-C differ depending upon concurrent HT use.